AAO-HNSF Primary Care Otolaryngology Handbook

CHAPTER 17

Pediatric Otolaryngology

Clinical Practice Guideline: Tonsillectomy in Children (Update) Clinical Practice Guideline: Otitis Media with Effusion (OME) Clinical Practice Guideline: Tympanostomy Tubes in Children Clinical Consensus Statement: Pediatric Chronic Rhinosinusitis

A high percentage of illnesses affecting children involve the ears, nose, and throat. Nearly all otolaryngologists treat children, and some treat only children. An excellent library reference on pediatric otolaryngology is the two-volume text by Bluestone, Kenna, and Stool. 2 You should refer to it often during your pediatric rotation. The most common pediatric disorder seen by the otolaryngologist and pediatrician is otitis media , so it is important to understand the spectrum of this disease. This disorder is presented in the Bluestone book in Chapter 5, Otitis Media. Foreign Bodies in the Ear, Nose, and Throat Let’s face it: Children seem to have a propensity for putting things into just about any orifice possible. Thus, they will often place pebbles, erasers, small toys, etc., into their external auditory canal (EAC). Treating this problem is usually a fairly benign process that can be dealt with in a nonemergent manner, but the exception to the rule is if there is a strong possibility of damage to the middle or inner ear. If this has occurred, the child may have lost sensorineural hearing, and may also be dizzy. Another exception is if the foreign body is alive! It is important to kill insects in the ear canal (usually drowning in drops of olive oil is a good choice) before removal. These children should be referred immediately to an otolaryngologist. Most commonly, the foreign body remains in the lateral part of the EAC. Remember that these young patients often become uncooperative and may require general anesthesia for the simple removal of the object, especially if prior attempts have been made to remove it. Therefore, unless certain, easy, atraumatic removal of the foreign body is completely assured, refer to an otolaryngologist.

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2 Bluestone, C.D., M.A. Kenna, and S.E. Stool. 1996. Pediatric Otolaryngology. Philadelphia, PA: W.B. Saunders Company, 1,677 pp.

Primary Care Otolaryngology